Do you think the US will eventually have a single-payer healthcare system like Canada?

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Active Member

Since this is one of Bernie Sanders' proposals but even long before (in the 90s, Bill and Hillary Clinton had made a strong push for it), the idea of a "Medicare for all" has been floating around for quite some time in American politics, I was wondering if this will ever come into fruition, either in the near future or further down the line.

So far, I haven't heard of other politicians or public figures in this current time besides Bernie Sanders come out with strong support for single-payer. Most want to "work within the current system", as in the way Obamacare did (When I first lived in the US as a college student some years ago, I got to see Obama's election, and I excitedly but naively believed that soon, perhaps even in a few years, the healthcare system would be just as it was "back home", not realizing what single-payer was compared to Obamacare and the complexity of it all and thinking that I just get a card that allows me to access care anytime anyplace, not realizing it doesn't work at some different clinic, or in the next town over).

However, I read that, depending on how you word things on surveys, explaining what it is, the majority of Americans actually want the single-payer system.

Apparently Vermont had at one point attempted it on a state level (there were plans to test it out on other states if it would have succeeded, I guess the way Canada did it provincially) but it didn't work out.

What do you think? Is single-payer still a probable direction the US system could go towards? I certainly hope so.

Active Member

I do wonder how strong the uphill fight would be, especially compared to other countries' reforms. But other countries at some point, including our own, once had to have started off at square one somehow, from having no public healthcare at all to having it.

Canada and the US didn't have that big of a difference in health care system before the 60s, and I heard that for Canada, when Saskatchewan first started it there was just as much opposition from the status quo as there is now in the US. Doctors went on strike, declared that they'd leave the province and even doctors from elsewhere had to be brought in by the government to fill in. But from the moment Saskatchewan had first tried it, to the moment that it was established nation-wide, not much more than a decade has passed, but a generation or two later, it has become such a strong part of our nation that we all take it for granted, forgetting that there was ever any opposition to it to start with. Not saying Canadian health care is perfect, and obviously it has its problems, but I'm just thinking that if reform can come so fast to Canada (in one decade or generation) as history showed, does our neighbour stand to also follow such a trajectory? Or is it still the case that American reform is especially hard and other countries' paths are unlikely to inspire or be instructive to it?

Most developed countries have universal health care systems (even if not our single-payer style), and even some that are developing have it too. I'm just wondering will the US still continue to "hold out", or will change eventually come too? I'm somewhat hopeful, the American public wants it too, but there are people that say the US is exceptionally resistant to change in this regard.

Also, in the 90s, Hillary, along with Bill Clinton supported single-payer and would have called it HillaryCare or ClintonCare, but now Hillary herself thinks it's impractical and argues against it, as opposed to Bernie who supports it.

So, basically Obama put RomneyCare into place which Romney supporters were against, and now Sanders favors instead what would have been ClintonCare and defends it against Clinton, who'd would prefer to stick to the more "practical" ObamaCare, which was originally RomneyCare, saying that Bernie's plans for ClintonCare are a pipe dream. How confusing.

I think partisan politics are such that people are loyal enough to their candidate or party that they'd be against the same idea if their opponent made it -- I don't think that's as much "a thing" for Canadians.

Senior Member

The Clintons never supported single-payer. It was a very complex and bureaucratic plan that sought a compromise with the insurance industry.

From Sanders' memoir, Outsider in the House:

"Bill and Hillary Clinton raised the healthcare debate to the highest level that it had ever reached in this country. They deserve credit for that. They also deserve credit for claiming that all Americans are entitled to healthcare. Unfortunately the complicated and compromised bill which they brought forth was not something that I could support.

Throughout that congressional debate - a debate ultimately decided by the millions of dollars that the insurance companies put into 'Harry and Louise' ads and a massive lobbying effort - a number of us, led by Representative Jim McDermott of Washington, worked hard for the single-payer system in Congress."

I realize that there is exceptional opposition by the establishment and insurance companies stateside, but as the video posted by King of Kensington showed, there was also just as much fierce opposition by our medical establishment when Canada first started it in Saskatchewan, yet less than a generation later, it went from unthinkable, radical plan for many people to "couldn't remember life without it".

So, what is exceptional about the US establishment that prevents the same path? Didn't Canadian insurance companies/the medical establishment fight equally as strongly against reform? Is it just the sheer size of the lobby in absolute terms that we don't, or well, didn't have, and that the US politics are influenced more by lobby groups since there are less restrictions on money spent on influencing them?

Senior Member

Canada got medicare during the Keynesian era, a time of welfare state expansion around the world. There were exceptional growth rates, unprecedented in capitalist history, and a "great social compromise" where business to some extent made its peace with the welfare state. By 1980s, neoliberalism was ascendant and it has put greater constraints on social democratic type reforms.

I would also add that the Canadian business lobby probably wasn't as sophisticated as the American one, and there's a greater emphasis on individualism in the US.

Obviously the insurance companies would stand to lose and strongly fight against it, but wouldn't many businesses possibly actually be in favor of it as they could possibly save money from having single-payer, over the current system seeing as how the burden would no longer be put on the employer to shell out money for the insurance?

I know there's a strong lobby of business interests against health care reform, but I can't see why there wouldn't be any powerful interest groups/lobbies in favor of reform, and why even among many people who favor it as their first or ideal choice, enthusiasm seems restrained/cautious and single-payer is still seen as "too ambitious" as opposed to just keeping the current system with only some slight tweaking.

If practicality and fiscal responsibility is the issue, isn't the current system also economically inefficient too and full of bureaucracy? If not the social democratic argument based on equality of access, why doesn't the argument "single payer will save money over the current system" or "the onus won't be on the employers/businesses anymore to pay for their employees" seem to be brought up or convincing to those who care about economics rather than the equality/rights argument.

New Member

Eventually there will be single-payer because of the fact that it's portable. Today, health insurance is tied to one's job. As Americans increasingly shift from one job to another, single-payer will become more appealling because coverage follows the worker as one changes jobs.

Canada doesn't really have universal health care. Have an infected tooth, you pay. Not a senior and need medicines, you pay. Need orthotics or mobility devices and not on welfare, you pay. Need physiotherapy, you pay. Want tools or other help to overcome addiction or mental health issues, you pay. The Canadian system is desperately dependent on its citizens having health benefits from their employers.